UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3A.   Dermatology:

ACNE MEDICATIONS

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

7.         If the patient is pregnant

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Excessive skin dryness, rash, peeling, redness, genital itching, sun sensitivity, nausea

Refill request is within reasonable time limit

¯

¯

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YES

NO

YES

NO

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¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel

 

 

UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3B.   Dermatology:

ANORECTAL PREPARATIONS

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Rectal irritation, burning, itching, redness

Refill request is within reasonable time limit

¯

¯

¯

¯

YES

NO

YES

NO

¯

¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel

 

 

UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3C.   Dermatology:

ANTIFUNGALS, TOPICAL

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Condition persists or worsens, irritation occurs, redness, itching or burning, blistering or swelling of area where applied.

Refill request is within reasonable time limit

¯

¯

¯

¯

YES

NO

YES

NO

¯

¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel

 

 

UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3D.   Dermatology:

BURN PREPARATIONS

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

7.         Last complete blood count (BCB), especially Leukocyte (20% leukopenia)

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Continued cough, dizziness, lightheadedness, fainting, fast or irregular heartbeat, rash, signs of angioedema (swelling of lips, face, eyes, tongue, difficulty swallowing, or breathing)

Refill request is within reasonable time limit

¯

¯

¯

¯

YES

NO

YES

NO

¯

¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel

 

 

UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3E.    Dermatology:

COUNTER-IRRITANTS

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

7.         If used frequently, verify with patient the size of the area where applied

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Tinnitus, nausea, or vomiting

Refill request is within reasonable time limit

¯

¯

¯

¯

YES

NO

YES

NO

¯

¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel

 

 

 

UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3F.    Dermatology:

MOISTURIZERS

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Rash, itching, redness

Refill request is within reasonable time limit

¯

¯

¯

¯

YES

NO

YES

NO

¯

¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel

 

 

UNIVERSITY OF WASHINGTON ACADEMIC MEDICAL CENTERS

Medication Refill Protocol

June 24, 2002

 

3G.   Dermatology:

STEROID OINTMENTS & CREAMS

 

A.        Determine from the chart or MINDSCAPE:

1.         Indication of medication

2.         Strength and dosage of medication

3.         Date of last physician/provider appointment

4.         Date of next appointment from physician/provider instructions

5.         Quantity of medication to last until next appointment or 12 months from last annual appointment if "PRN"

6.         Other medications taken concurrently, check for drug interactions

7.         If patient is using as an occlusive dressing

 

B.        If information in "A" is available in the chart or MINDSCAPE:

1.         Authorize the refill

2.         Update the Medication List in chart then record refill

3.         Send copy of Refill Request Form to primary physician/provider

 

C.        If information in "A" is not available in the chart or MINDSCAPE, telephone the patient for the information, and, in addition, check for:

 

Adverse Drug Reactions:

Compliance:

Excessive burning, itching, redness, numbness in where applied, stinging. Cushing's syndrome hyperglycemia

Refill request is within reasonable time limit

¯

¯

¯

¯

YES

NO

YES

NO

¯

¯

¯

¯

Contact primary or preceptor MD

Follow procedures in "B"

Counsel